Ectopic pregnancy: complications and treatment

On Elia's blog, we have already talked to you about ectopic pregnancy. Today, in this second part, we will talk about how an ectopic pregnancy (EP) is diagnosed, what the treatments are and if there are any complications.

Can an ectopic pregnancy be prevented?

An ectopic pregnancy cannot be prevented, but risk factors can be reduced and complications prevented. Some things you can do include:

• Protect yourself during sex to avoid getting an STD or pelvic inflammatory disease. This reduces the risk of ectopic pregnancy.

• Take a pregnancy test if your period has stopped

• Go to your doctor as soon as you have any doubts about your pregnancy to get a diagnosis and undergo the necessary tests

How is an ectopic pregnancy diagnosed?

To detect a possible EP, a vaginal exam can be performed. Indeed, if the woman has an ectopic pregnancy, the practitioner can feel a small mass next to the uterus. This is quite painful in the "cul-de-sac" at the intersection of the vagina and the uterus.

Additional examinations are also performed because the vaginal touch is not sufficient. Most often, a blood test is taken to measure a hormone produced by the placenta: chorionic gonadotropin (HCG). This hormone is characteristic during a pregnancy but varies differently in an ectopic pregnancy. During a classical pregnancy, the level of this hormone doubles every 48 hours, the evolution is much lower during an EP. An ultrasound will also be performed to confirm the diagnosis (pelvic, uterine). Indeed, if a woman is pregnant but her uterine cavity is empty, it means that she is having an ectopic pregnancy. In addition, during an ultrasound, blood can be detected in the abdominal and pelvic cavities. Sometimes, a laparoscopy can also be performed to detect an EP (fiber optic tube, attached to a camera, incised inside the uterus), as well as a monitoring of the progesterone level in the blood.

It should be noted that ectopic pregnancy is a surgical emergency. Once detected, it is treated directly. Indeed, the longer one waits, the more the pregnant woman risks a hemorrhage which is sometimes fatal. If the pregnant woman is treated before a potential hemorrhage, it is rare that things become extremely complicated.

What is the treatment for an ectopic pregnancy?

If an ectopic pregnancy is diagnosed, and as we have just said, surgery must be performed urgently. Indeed, as the embryo is not developing in the right place, the fallopian tube may be ruptured and cause internal bleeding.

It should be noted that in 10% to 20% of cases, EPs lead to spontaneous miscarriage and the egg is eliminated spontaneously by the human body.

Two medical procedures are then considered depending on the case:

• In the case of unruptured EPs (rather at the beginning of pregnancy): an injection, by the health professional, of a drug (methotrexate), which will stop the cell development and destroy the egg. He injects it directly with a needle into the fallopian tube by intramuscular route.

• A laparoscopic procedure: the surgeon will perform a laparoscopy under anesthesia by incising the navel to slide an optical tube. The goal is to open the fallopian tube (which is where the egg most often develops in the case of an EP) and extract/release the egg, while stopping any bleeding. This surgical procedure is quite benign as it only requires opening the navel a few millimeters.

• Removal of the fallopian tube: in the most serious cases, i.e. in case of rupture of the tube or repeated EP, the practitioner performs a laparoscopy as explained above, but must perform a surgical resection, i.e. the surgical removal of a part of an organ or a pathological tissue. For example, he removes the fallopian tube. This procedure may sometimes require opening the abdomen, as in a cesarean section.

What are the complications or consequences of an ectopic pregnancy?

Contrary to what one might think, an EP as such does not have any consequences on fertility. In fact, there are about 60% of spontaneous pregnancies or IVF pregnancies within 2 years after an EP. However, the rate of recurrence of an EP in subsequent pregnancies is higher, between 10 and 30%.

However, a woman's fertility will depend, for the most part, on the treatment she has received. If a woman has had both fallopian tubes removed (especially in case of recurrence), a natural pregnancy is no longer possible. The only way to have a child is therefore to turn to IVF or adoption.

After an ectopic pregnancy, medical follow-up will be all the more important, especially during a future pregnancy, to verify that the embryo has implanted in the right place this time.

Whatever the circumstances and stages of your life, Elia is close to you, with a range of menstrual pants designed to ensure your comfort in the most delicate moments.